1. VAGINAL DISCHARGE DR Sathisha Nayak Dept. of O & G MMMC

2. IDENTIFY !!

3. VAGINAL DISCHRGE OBJECTIVES : 1.WHAT IS LEUCORRHOEA? 2.IS IT NORMAL? 3. NORMAL VS BNORMAL 4.CLASSIFICATION 5.COMMON CAUSES 6.CLINICAL FEATURES 7.EVALUATION 8.MANAGEMENT

4. LEUCORRHOEA EXECESSIVE VAGINAL DISCHARGE NOT DUE TO INFECTION(EXECESSIVE CERVICAL MUCUS OR VAGINAL TRANSUDATION) ECTROPION, CERVICAL TEARS.

5. IS VAGINAL DISCHARGE NORMAL? COULD BE PATHOLOGICAL YES –SOME SITUATIONS IT CAN BE - PUBERTAL - PREGNANCY - PREMENSTRUAL - OC PILLS -SCANTY,NO SMELL,WHITISH,NO ITCHING NOT BLOOD STAINED.

6. NORMAL CERVIX

7. CLASSIFICATION PHYSIOLOGICAL PATHIOLOGICAL - INFECTIVE - NON INFECTIVE- NEOPLASTIC - ATROPHIC - ALLERGIC,FB

8. INFECTIVE CAUSES VAGINAL - CANDIDA VAGINITIS - TRICHOMONIAL VAGINITIS - BACTERIAL VAGINOSIS CERVICAL - GONORRHOEA CERVICITIS - CHLAMYDIA CERVICITIS

9. CANDIDA VAGINITIS AGE- 20-40Y COMMON IN – PREGNANCY DIABETIC OBESE WOMEN FEATURES - CURDY WHITE,ITENSE ITCHING EXCORATION OF VULVA SMEAR- 10%KOH-FUNGAL HYPHE SEEN TREATMENT-CLOTRIMAZOLE-100MG BDx7D 200MGBDx3D RECURRENT -FLUCONOZLOE 150 MG WX4W

10. CANDIDA VAGINITIS

12. TRICHOMONIAL VAGINITIS AGENT - TRICHOMONIA VAGINALIS AGE -20-40YRS,SEX ACTIVITY FEATURES GREENISH,FROTHY,COPIOUS,ITCHING STRAWBERRY SPOTS ON VAGINA VAG. SMEAR-MOTILE ORGANISMS TREATMENT- METRONIDAZOLE - 200XBDX7D OR400XBDX3 -COUPLE TREATED TOGETHER

13. TRICHOMONIAL VAGINITIS

14. BACTERIAL VAGINOSIS AGENT–G.VAGINALIS+ANAEROBIC AGE -20-40 YRS FEATURES-WHITISH GREY,COPIOUS NO ITCHING,FISHY SMELL VAG.SMEAR-CLUE CELLS TREATMENT-METRONIDAZOLE500XBD X7DAYS

15. BACTERIAL VAGINOSIS

16. HOW TO ASSES..? DETAILED HISTORY COLOUR AMOUNT,SMELL,ITCHING RELATION TO COITUS /MENSES,pH CLINICAL EXAMINATION-EX GENITAL P/S EXAM INVESTIGATIONS-VAGINAL SMEAR -CULTURE

17. CERVICAL INFECTIONS GONORRHOEA-NEISS. GONORRHOEAE -85 %ASYMPTOMATIC - MUCOPURULANT - SMEAR FROM CX O&URETHRA - INTRACELL. GM –VE DIPLOCOCCI -SINGLE DOSE CEFETRIOXONE

18. CERVICAL INFECTIONS CLAMYDIA-CL.TRACHOMATIS AGE -20-40 MUCOPURULANT SEXUAL TRANSMITTED FLOROSCENT ANTIBODY TEST/CULT. DOXYCYCLINE 100XBDX7D

19. CERVICAL INFECTIONS

20. BEWARE ! IN ANY VAGINAL DISCHARGE R/O- -CARCINOMA CERVIX,CA ENDOMET. (FOUL SMELL OR BLOOD STAINED) -POLYPS,FB,VAG DOUCH(CHEMICAL) -STD-PARTNER SCREENING -DIABETES/HIV IN CANDIDA

21. DYSPLASIA

22. IDENTIFY

26. THANK YOU